CAMDEN — Six first responders were in the ambulance with the patient and her husband, using shears to remove heavy clothing, performing chest compressions, ventilating her lungs with a bag valve mask, setting up a Lucas automatic chest compression device, and eventually activating cardiac shocks. It had been a witnessed event, but even with those, the return of heart beat only occurs, on average, seven to 10 percent of the time.

The toboggan racer transported to Pen Bay Medical Center Sunday, Feb. 8, and then airlifted to Maine Medical Center in Portland, is expected to be released from hospital care on Valentine’s Day, according to the Camden Fire Department.

In a WMTW Channel 8 feature that aired Feb. 12, “Lillian Rinaldi, known to her 13 teammates as ‘Lil’, collapsed moments before her turn.”

The initial quick and coordinated actions of a network of responders played a vital role in Lil’s recovery: North East Mobile Health Services, Camden Fire and Rescue, Ragged Mountain Ski Patrol.

Outside the ambulance that had pulled up to the scene in Tobogganville, two Camden Police officers managed the pedestrian crowd as the 35th Toboggan Championships, Camden’s annual winter celebration at the Camden Snow Bowl, remained ongoing.

The officers stood with Camden Comets teammates, who had just witnessed their friend’s collapse and who had appealed for medical help. Help arrived.

Each February, Snow Bowl management, Toboggan Committee members, Ski Patrol, Police, Fire, and EMS review their master plan for the popular Championships, knowing the event draws thousands of locals and visitors to the Snow Bowl and the iced-over Hosmer Pond, and always under variable weather conditions.

It is not a task taken lightly. The chute is long and steep, the venue can get crowded, skiers are also at the Snow Bowl on the Ragged Mountain slopes, and the chance for injuries runs high. Almost two decades ago, a number of toboggan racers were injured in a collision, sending several to the hospital. The event planners emphasize being prepared. 

In their favor is local knowledge of the area and countless hours of training in various skills, including CPR. And the Fire Department had acquired this year, thanks to a grant from the Stephen King Foundation, an automated Lucas chest compression device. That resuscitation ensures strong and steady chest compressions to patients suffering cardiac arrests and less strain and risk for caregivers. 

As it does for the Fourth of July fireworks celebration at Camden Harbor each summer, the CFD asked more personnel to be on hand for at the station on Washington Street during toboggan weekend’s Friday, Saturday, Sunday event.

“We bring in more staff for events with large groups of people so that our folks are already here,” said Camden Fire Chief Chris Farley. “Having them here reduces the response time.”

At the mountain, the Ragged Mountain Ski Patrol was likewise prepared, with extra patrollers in their red coats on the ice of Hosmer Pond with a first aid station, as well as more on the mountain for skiing safety.

The response to the cardiac emergency in Tobogganville was immediate, and skilled.

February is Heart Health Month

February is American Heart Month and the National Heart, Lung and Blood Institute makes no bones about the focus.

“Heart disease is the leading cause of death in the U.S. but impacts some communities disproportionately,” the NIH says. “Join efforts around the country to promote heart health in your community.”

The CDC also emphasizes heart health this month with resources and tools for recognizing heart disease and improving outcomes.

Camden Fire and Rescue has been aiming for improved cardiac outcomes in various public institutions around town.

In addition to purchasing the Lucas device, which hangs prominently in the fire engine bay where it can be grabbed off the wall in seconds, the fire department is working to ensure that public buildings have AED machines that are compatible with those carried by CFD and North East Mobile Health Services, so that the cables attached to the patient can be converted to the CFD’s AED machine for continued care. 

So far, the Camden-Rockport Middle School, Camden Public Library, Camden Opera House, Camden Town Office and the police cruisers now have compatible devices.

Most importantly, however, the CFD wants the public to learn CPR, and know what to do in a cardiac emergency. CPR is a rational and simple sequence of actions that anyone can help do. 

“You could talk to a 911 dispatcher, and they’ll walk you through it, which is a great thing that we have,” said Connor Howland, a Camden firefighter/EMT and Camden Hills Regional High School senior. “But it is better if people already know CPR so they can start it before they even call 911.”

Learning to recognize a cardiac event is a major first step. Having an understanding of the chain of survival, which includes being able to identify cardiac arrest is also beneficial.

Each spring, seventh graders visit the Camden Fire Department over the course of two days and learn CPR. They station on mats spread out in the fire engine bays, while the engines are parked outside. Inside, the students practice doing chest compressions and attaching AEDs to dummies. And, they practice using their voices to sound the alarm and get emergency response started.

CFD is interested in expanding the CPR training to any group. Organizations are welcome to call the fire station and arrange a class.

“Getting more people educated on CPR, and educated on that chain of survival, when they witness an event like that [Sunday’s incident], they can have just that much more of a chance of survival,” said Howland.

Both he and his friend Bennett Cohen, also a senior and Camden firefighter, are recent EMT graduates. This past weekend, they had been assigned to station coverage with other fire department and North East Mobile Health ambulance service personnel.

Both Howland and Cohen were curious about Sunday’s toboggan competition progress, and with permission, they left downtown Camden and headed to the Snow Bowl to take a look.

The call came through from Knox Regional Communications Center at 1:18 p.m., just as the two were walking off the Hosmer Pond ice near the parking lot and the ambulance that was stationed near the tennis courts. They could hear people running toward the ambulance yelling for help and they jumped aboard that ambulance to lend North East’s EMT Heidi Mansfield a hand. 

At the scene, NEMHS Advanced EMT Maegan Randlett-Boley, who just happened to be in Tobogganville grabbing lunch, was already providing patient care, and the three, plus Ragged Mountain ski patroller Lynda Clancy, arrived to assist her.

 “Maegan specifically provided some clear directions to every single person at the scene,” said Cohen. “How to provide care to the patient, and how to move the patient into the ambulance.”

Lil was transferred from the cold ground into the back of the ambulance and the crew got to work, each according to their levels of training, and with coordinated communication and consistent cardiac emergency care.

In a matter of minutes, paramedics Lina Powers and Matt Heath arrived from their base at Camden Fire Dept., as did Camden firefighter/EMT Jacob Wilder.

And just as the Lucas device was being set up and started, Lil’s heartbeat returned. But her care did not stall.

It’s not uncommon for responders to spend 40 minutes at an emergency scene on just CPR. But on Sunday, it was a swifter course of action. The initial call came at 1:18 p.m. from Knox Regional Communications Center and the North East ambulance was en route to the hospital at 1:33 p.m., with arrival at the hospital at 1:44 p.m. All accomplished in less than 30 minutes.

For every minute, a patient’s chances of survival decrease. For an unwitnessed cardiac arrest, survival chances are even less.

“It’s really amazing that somebody was with this patient when they experienced this medical episode,” said Cohen. “If we had not had a provider on scene within seconds, the chances of surviving would have decreased dramatically.”

“NEMHS, Camden Fire and Rescue and Ragged Mt. Ski Patrol responded to a cardiac arrest today and through coordinated decisive action, the crews achieved ROSC (return of spontaneous circulation),” wrote Farley, on the Camden Fire and Rescue Facebook page. “A code save is rare in the EMS world. Every provider knows that odds. That reality makes today’s outcome extraordinary!”

In a post-event debrief that took place Monday afternoon in the Camden Fire Dept. meeting room, approximately 25 first responders representing Camden Fire Dept., North East Mobile Health Services, Ragged Mountain Ski Patrol and Toboggan Committee members spent more than an hour deconstructing the response, the timeline, patient care, and communications. What went well, what to improve.

In the end, however, there was agreement that the safety plan put in place for 35th Annual Toboggan Championships worked well, that collaborative teamwork prevailed, and the response from all responding agencies — fire, EMS, patrol and police — was seamless.

And there were big smiles as the news filtered in that Lil was OK, and doing well at the hospital. 

“Job well done,” said Farley. 

Reach Sarah Thompson at news@penbaypilot.com